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Infertility Corrective Surgeries

Dear couples your doctor is also involved equally in your journey and everyone expects baby to come soon . . . !!!!

 

Although Infertility is faced by so many young couples, most of the time it is sub fertility. About 84% couples achieve fertility by one year of marriage and 92% by end of two years. But with advancing age and stressful daily living to achieve fertility has become one goal. And once couple become anxious every month is testing their tolerance

In case conception is not happening naturally, doctors evaluate male and female factors. Males can have 35% contribution in terms of having low count or motility or difficulty in performance. Females on the other hand can contribute to 50% causes {ovarian, tubal, uterine, cervical, endocrinal immunological} and almost 10% causes are unexplained medically. All these unexplained couples are then asked to follow assisted reproduction technology. Hence to search and correct these 50% problems, pt. has to be evaluated surgically using hysteroscope & laparoscope.

If fallopian tubes have problem, Hysteroscopic cannulation is done for proximal blocks. Tuboplasty & Fimbrioplasties are done laparoscopically for distal blocks. Any hydrosalphinx (Fluid collection in tubes) are always delinked..

Patients who have been ligated or have previous ectopic surgery can recanulate tubes.

If peritoneal factors like adhesions are present laparoscopic adhesiolysis is done.

If endometriosis is present in pelvic cavity, it is burnt laparoscopically and endometriotic collected cavities are drained.

If fibroid is present in walls of uterus, laprascopic myomectomy is done & all myomas are enucleated from uterine walls.

If uterine cavity has fibroid protruding inside, hysteroscopic myomectomy is done.

If there are bands in uterine cavity (Synichae) they are snipped off hysteroscopically and cavity is again made clear.

If there is polyp (growth) inside uterine cavity hysteroscopic polypectomy is done.

Sometimes cavity has septum (thick dividing curtain) which is then ressected hysteroscopically.

In cases of shrunken uterine cavities metroplasty operations are done so as to enlarge cavity.

Coming to ovarian pathology if polycystic ovaries are present, laparoscopic drilling of cysts help to achieve good ovulation with minimum injectables that are given for ovulation induction.

Whenever large ovarian cysts are present they are drained and cyst walls are removed, care is taken to maintain as much as normal ovarian follicles. Endometriomas are also drained avoiding spillage and all hidden endometriotic patches are fulgurated (burnt). Ovaries which are adhered to pelvic wall are made free from ovarian fossa.

So in short couple tries for 6months naturally with little help of medicines and follicular studies to plan their fertile period. Then next step is laparohysteroscopic evaluation and corrective surgeries. If pregnancy does not happen post procedure within one year of time, couple should take help of assisted reproduction technology. So as to achieve fertility by end of two years of trying.

Dear couples your doctor is also involved equally in your journey and everyone expects baby to come soon . . . !!!!

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